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Home My WebLink About5815-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No.. Z. ~91~- ... Date ............ .IlOV .....~2 .... , 19.72. THIS CERTIFIES that the building located at . .1~/$..l~&dOW.. L~O ........ Street Map No.Y~;~,. ][I~. Block No ........... Lot No..39 ..... Ma~;.~t, tU~ ... Ii,Y, ...... conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... &pl'~...-$?, 19..~.~ pursuant to which Building Permit No..~8~[.~Z. dated ......... &pr~...~.~...., 19.~., was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . l~.r~v&t$, oae .f~ly. tl.~ll~ ...................................... The certificate is issued to . .~. JttJ.~_~0k...l~.~.~.t0.~. ........(~..0~ ...................... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval l~..t~.... $05..~.9~.~....by..R.~. ¥.:[.l!& ..... UNDERWRIT[RS CERTIFICATE No .... ][. ~.~]~ .... 0~t...~..~.~.~ .................... ttOUSE NUMBER...3 .~. ...... Street... ~.O0.d~D~..~¢~ ................................. Building Inspector / ~ORM NO. ~ TOWN OP SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5815 Z Permission is hereby granted to: ................ ~lt~£t.r~ ......... .11,.~, ....................... to ... ~t~6.. ~e~.. e~e..-Eea~t.i~,.-.d~ee '].'ii~ .................................................................................. at premises located at .~..~{) .......... |(~:u~oj~..~.~6e,~,e,'~ .......................................................... ......................................... ]~#~la~..L~ne.....~ttt.tuek .......... N.,~, ............................................... pursuant to application dated .............................. ,~),-.~..~.....~.~...., 19..~.., and approved by the Building Inspector. ~ ;; iNCLUDES '-,- ?Eh.aVE EXCESS FILL DRWE'NAY C ,, TION ~ CZSspoOL CaFeS ~TION ~- .,~,,~, , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE ~OUTHOLD, N. Y. Examined .... ~.,~ ............. ~ .......... , 19...~.~ ~/ pplication No ............... ~pr~ed ....................... ~ ........ ..%...., 19...~... Pemit No...~../. ......... Disapproved a/c ............................................................................................ ....... ..... ' ............ APPLICATION FOR BUILDING PERMIT ~ Date ...................... .?,.~...r..l.,~,. ...... .1..?..., 19...?.... ..... 1NS. T. RUCTIONS a. This application must be completely filled in by typewrite;' o'r i~ ,ink and submitted in triplicate to the Building Inspector, witF 3 sets of plans, accurate plot plan to scale. Fee according to-,schedule. ,, b. Pict plan showing location of lot and of buildings on p~'emises,..relationship to adjoining premises or public streets or areas, anc~ giving a detailed description of layout of property must he drawn on diagram which is part of this application. c. The work covered by this application may not he commenced before issuan,ce of' BuildJn,q Permit. d. Upon appyovel of this application, the Building Inspector will issue a Buildin~'Pem~it to~thd app~cant. Such permit shall be kept on the premises available for inspection throughout the work. '~ ,, e. No building shall be occupied or used in whole o"r in part'for any purpose whatever until a Certificate of Qc. cupancy shall have been granted by the Building Inspector. ' , '. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction Of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. Contractor Edward Abitz ~ Inc (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant Js owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... ~.~t:L:C~zc]c.,~t~.l;~. ................................................................................................... ~ If applicant is a corporate, signature of duly authorized officer. · ~, ...................................................................................................(Name and title of corporate officer) (~)0~ '~ ]~ Matt Est 1. Location of land on which proposed work will be done. Map No.: .................... Lot No....~. ..................................... Number.. a Matt tuck N.Y.' Street and ....... ;~/~...~.{t .. ~Q~r...~.~ f~ ........................ ~. ................................................................................ ~ ,~/~-'~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .....~.a..g..s.~.~..~,.a~ ...... i ............................................................................................... ~b. Intended use and occupancy ...... .eno .- ~'&m.i.~.~r.. ~we ;L.l.~r*e ......................................................... ~.-~... 3. ~Nature of work (check which applicable): New Building .......~ .........Addition ..................... Alteretion....~...~ ...... Repair ............. . ............ Removal ......................... Demolition ........................ Other Work .................................... (Description) 4. Estimated Cost ...... ~6 ~.OQO ........................... Fee '"~(~""~t~'l~'l~'~i~l'~'~iii~l'~'l~i;'~'l~l'i'~i~i ................................. 5. If dwelling, number of dwelling units ...:;i. za~ ....... Number of dwelling units on each floor ......................................... If garage, number of cars ..... ~.¥..o. ............................ ....................................................................................... 6. If business, commemial or mixed occupancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front ..................... Rear ........................... Depth ................................... Height ........................................................... Number of Stories ............................................................................. Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... Depth ............................................. Height ..., ........ ~ ....... , ................... Number of Stories ........................................ 8. Dimensions of entire new construction: Front ..... 62. ............... Rear ............................ Depth ....,P.8/...22. .............. Height ................................................. Number of Stories ...D/~e ............................................................................... 1 O0 g. Size of lot: Front ...~.~0 ............................ Rear .......................................... Depth ......~0 ....................................... Height .................................................... Number of Stories ...................................................................................... . 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ Il It 11. Zone or use district In which premlles are situated ............ ~.....~,;j~.J; ........................................................................ 12, Deal propo!ed construction violate any zoning law, ordinance or regul~tion: ...... .,mo...,,, ........................................ 13. Wllllotberegraded ..........7.~ ..................... Will excass fill be removed from l~remi~es~: [ ] Yes [:~ No 14. Name of Owner of premises .~;~tl.t, ucY,;:~mt~te~ ............................................................................................. (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Address) (Phone No.) Name of Contractor ......ff,,..~T~t,~r...Ce~.t,l~ae~/~...[,ne ....... [~.~j-l_ff3t:[~. ...................................................... (Phone No.) PLOT DIAGRAM [,o~ate ~learl¥ and di~tin~!¥ all buildings, whether existing or proposed, and ind cate ai set-back d me~a ons from groper-fi/lines. Give street and block number or description according to deed, and shew street names and indic, ate wheth- er interior or corner lot. El'ATE OF NEW YORK, ) COUNTY OF ...... ~tJ-P-PO ].~. ............................ ) Edward Abitx ............... ,,.,,. .............................. ,...., ................................................ being duly ~worn, deposes and s~ys that he is the al~plican~ above named. ~Name of individual #iaa~n~ aontracO He ~ the ............................................... .~..01~.~..$.~.~. ............................................................................................................................ , ......... {Contractor, agent, corporate officer, etc,} of etlid owner or owners, and is duly authorized to perform or have performed the said work and to make and file this applicat on; that ell statem#ntii ~ontained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mal~ner mt forth in the application filed therewith. JUDITH T. BOKEN Notary Public, State elc New Yo~ · ' -- Ne, E~2-Oa.,&49~2 Suffo k County ,~ ....................... ........ ........ SUFFOLK COUNTY DEPAHTHENT OF HEALTH APPLICATION FOR APPROVAL TO CONSTRUCT PRIVATE SEWAGE DISPOSAL SYSTEMS Date ~/-/3 - ~ ~- Approval to construct said systems is requested,pertinent data herewith: 1-Applicant /~, ~. ~//~ .' ~ Phone~2~-~//~6-Sub div..~- ;~-. ~-~ ~A,~-~-~ Address ~.~.. ~ ~ -~F~-~/ ~2~r'- J ~-r~ /Q./,¥ 7-Section 2-Detailed pr6perty location ~-"/~ ~¢~J'~F ~'~/~ 8-Lot No. ~ ~ , _. Hamlet Town 7'~W/~ '~ ~ k/> 9-Private well? x/r_ ~ 3-Public water supply name Distance to nearest main S-Lot Size: Width~ft. Length ~-~ft. (also enter on center plot plan below:) 5-Dwelling: Single Family ~.~ Two Family? ~ ~Oellar? ~ ~Slab? ~_~Crawl Space? ~ ~ 10-Proposed syste~: Septic tank .F ~Precas~.~Cesspools ~ /Shallow pools ~ ~Other / / il-Septic tank inside dimensions. V~lume~._~als.Length ft. Width___ft. Liquid depth ft. 12-precast sections: ~ ~FNumber~6~Square Ft. Cesspools: Block sizeL___incs.D ins. H ins. Total blocks below inlet: ~1 ~2 ~3 PLOT PLAN Capacity ~als. Street Indi No "Construction of authorized installation: Data Feet 0 2 ~/ 6 ~ 8 12 ~6 18 ~te th will be in can be installed on this Plot. Date (10/65 evis.) S-15 The Undersigned CERTIFIES: accordance with the Suffolk County Health Departments' current Standards, Bulletins, and amendments thereto, covering Private Sewage~isposal Systems". Date 3/7 ~ Signed C~ ~ , ~ ! Owner or Builder ~ ' FOR HEALTH DEPARTMENT USE ONLY. Based on the information presented herewith, it is the opinion of the Health Department, that an adequate and satisfactory Sewage Disposal System ~'o ~ /~ Cf SUFFOLK COUNTY HEALTH DEPARTMENT DATE NOV 1 0 1§72 M.D. ~. ~.~?-//~/ l o! $~ The sewage disposal and water supply facilities for the st:ucture located at have been inspected bg this Department and found.to be sat~is£act.or¥. Chief or ~enera- ~ngineerin~ ~erwees / / NOrD · -- MONUM~N ~* REVISIONS YOUNG & YOUNG 400 0$TI:~ANDEM AVENUE, MIVERHEAD, NEW YOMK ALDEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: EDWARD ADITZ L0T NO. Sg;' MATTITUCK ESTATES, INC." AT MATTITUCK GUARANTEED TO: TOWN O~' SOUTHOLD SUFFOLK CO., DATE: AUG. 24, 1972 NO. 72 -~'71 ~' SCALE: j. = 40'